When Women Delay Motherhood — A Red Alert for Reproductive and Social Health in Thailand
August 7, 2025
Record-Low Birth Rates: A Sign of Alarming Trends
According to Thailand’s Ministry of Public Health in 2024, fertility rates have plunged to 1.08 births per woman—lower than both Japan (1.26) and Singapore (1.05). Over 30% of first-time mothers are now aged 35 or older—double the rate from a decade ago.
Pregnancy after age 35 brings significant risks:
- 2–3 times higher rate of fetal abnormalities
- Increased risk of preeclampsia and gestational diabetes
- Greater likelihood of miscarriage than women under 30
Most concerning is the mindset of “modern medicine will fix it.” Yes, medicine has advanced—but it cannot reverse the biological aging of the female reproductive system.
Hormonal Shifts Impact More Than Fertility
Women who delay pregnancy often experience undiagnosed endocrine disorders such as PCOS, ovulatory dysfunction, or progesterone deficiency, leading to:
- Irregular menstrual cycles
- Infertility
- Psychological and sleep disturbances
- Elevated risks of cardiovascular disease, hypertension, and dyslipidemia in middle age
A 2023 study in the Thai Journal of Obstetrics and Gynaecology showed that untreated endocrine imbalances in women during their 30s increased their risk of post-menopausal cardiovascular disease by 2.4 times.
The Critical Role of Early Gynecological Assessment
As a physician trained at Mahidol University and experienced in Singapore, I believe postponing gynecological screenings because “there’s no plan for pregnancy” is a grave mistake. At Samitivej Sukhumvit Hospital, we offer:
- 4D ultrasound assessments of egg reserve, uterus, and ovaries
- Hormone profiling (AMH, LH, FSH, progesterone) to evaluate ovarian reserve
- Counseling on egg freezing for those not ready to conceive now but wishing to preserve fertility
For patients with concurrent cardiovascular symptoms or hormonal disorders, I collaborate with cardiologists for comprehensive evaluation—detecting early hypertension, arrhythmias, or elevated cholesterol during gynecological screenings.
Real Cases That Still Resonate
One patient, 39, unable to conceive after two years of marriage, was diagnosed with premature ovarian insufficiency. “I wish I had come earlier…” she told me. But time cannot be reversed.
On the other hand, a 33-year-old client underwent endocrine screening, chose to freeze her eggs, and now continues her career knowing she still has the choice to become a mother—on her terms, safely and proactively.
A Compassionate Plea from an OB-GYN
If you are between 25 and 35 without immediate plans for pregnancy, please consider reproductive health screening—not to become pregnant right away, but to understand your body and prepare for your future. Today’s foresight may spare you tomorrow’s regrets. Don’t let the “silent” ticking of your biological clock lead to a bumpy, anxious journey. Let modern medicine and trained professionals walk with you from the start.
Reproductive Health Is More Than Personal — It Reflects Our Nation’s Future
Low birth rates are not just individual concerns. They signal threats to demographic stability, workforce sustainability, and social welfare systems of Thailand. And these threats begin with the postponement, the silence, of each individual.
I am Dr. Nalinee Chansiri, and I am ready to listen and support you at every stage of your journey toward motherhood.